What
do you do after a positive home pregnancy test? Call your doctor and get a blood test done. This test
will tell you how much of the pregnancy hormone, HCG, is in
your blood and approximately how far along you are. This hormone
starts to circulate your body once the embryo has implanted
in the uterus. It is actually the fertilized egg that secretes
HCG. This hormone stimulates the cyst on the ovary, the corpus
luteum, to produce more progesterone, which will maintain the
pregnancy. This hCG/progesterone system sticks around till
about 12-14 weeks until the placenta is fully functional and
takes over progesterone production. At that point the cyst
goes away and HCG levels drop and arenít needed. Many doctors
do a quantitative blood test to measure the exact amount of
HCG present and make sure it is doubling every 2-3 days. If
it isnít then there might be complication or the pregnancy
might be in danger. You might have several of these blood tests
done in the first 2-3 weeks to make sure all is good. Some
doctors donít bother to do a quantitative test and just do
a yes or no confirmation blood test, the qualitative test.
It basically says the same thing as a home urine test. If there
is more than 5 mIU of HCG in the blood then a yes will come
back from the lab.

Once
the pregnancy has been confirmed, you will come in for
your first appointment at approximately 6-8 weeks along. You
will get an estimated due date (EDD) and have a series of tests
done. Besides the normal blood pressure, temperature, and urine
protein test, you will have a huge blood draw at this time.
You will also be asked about you and your partnerís complete
medical history and immediate familyís medical history. You
will also get a pelvic exam to see how you are progressing
and that all is normal. You will also get to hear your babyís
heart beat for the first time and possibly even get a first
picture. A complete series of tests will be performed on this
blood to rule out many possible complications. Here is a list
of the tests that will be run on your blood at this time.

for
evidence of previous exposure to chickenpox (varicella),
measles (rubeola), mumps, or German measles (rubella).

for
cystic fibrosis (this is a new one).

for
sickle cell trait or disease because they're at higher risk
for having sickle-cell anemia, if you are from African or Mediterranean origin.

Routine Visits and Testing

As long as your pregnancy is not high-risk you will go to
see your doctor once a month till you are seven months along.
At this point you will be seen twice a month to make sure there
are no signs of early delivery or development of later pregnancy
problems, such as high blood pressure or extreme edema. Once
you hit your ninth month you will be seen weekly till your
delivery. At different points in your pregnancy, you will have
to give another blood sample to have gestational specific tests
done. Some of these tests are optional and some are a must.
You will be screened for gestational diabetes at twelve weeks
if you are at high risk of having it. Women who have had a
baby weighing over nine pounds, a family history of diabetes,
are 30 or older, or obese, will be required to test at this
point. All other women will be tested at 28 weeks. This test
requires that you eat a huge carbohydrate breakfast or fast
and drink a surgery drink. For the breakfast choice you come
in one to two hours later and have your blood draw. For the
drink test, you come in and drink and wait an hour to have
blood drawn. If the test comes back high for blood sugar than
you are re-tested in three hours to see if you have gestational
diabetes. The most common things to expect are a urine sample,
measuring of the uterus, weight check, and hearing the babyís
heartbeat.

There are a wide variety of other prenatal blood tests that
one can choose from. These can help predict the likelihood
or presence of certain genetic or developmental diseases.

Alpha-fetoprotein
screening (AFP) can be done between 16 and
18 weeks. The level of alpha-fetoprotein, a protein produced
by the fetus, can be measured in the woman's blood. If the
level is high, there is a higher chance she is carrying multiples,
the baby has spinal bifida or other neural tube defects, or
they are just high and nothing is wrong at all. If the level
is low, this could indicate chromosomal issues like Downs Syndrome
or other chromosomal anomalies. This test can tell you are
at higher risk for certain issues but not that the outcome
is certain. More tests will have to be performed to be sure.

Multiple
marker screening (also called a maternal serum screening,
triple screen, triple marker, quadruple screen, quad screen,
quadruple marker, or quad marker): Also between 16 and 18 weeks,
your doctor or midwife may measure the levels of certain hormones
in your blood, along with AFP. For this screening, a sample
of blood is drawn from the mother to measure the level of AFP,
as well as the levels of HCG (human chorionic gonadotropin)
and estriol, which are produced by the placenta. The levels
of these three substances (which is why the test is often called
the triple screen or triple marker) in the blood can help doctors
identify a fetus at risk for certain birth defects or chromosomal
abnormalities. The test is called a quadruple screen (or marker)
when the level of an additional substance, called inhibin-A,
is also measured.

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